Progressive strap assembly for use with an orthopedic device

ABSTRACT

A progressive strap assembly includes an elongate, inelastic body having first and second ends, and an elastic body having first and second ends, the first end of the elastic body anchored to the second end of the inelastic body. The elastic body is arranged to stretch a plurality of lengths and has a maximum stretchable length. A tension limiter is connected to the first and second ends of the elastic body and is arranged to inhibit a predetermined stretchable length of the elastic body short of the maximum stretchable length.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.14/148,981, filed Jan. 7, 2014, which claims the benefit of priority ofU.S. provisional application No. 61/758,894, filed on Jan. 31, 2013, andU.S. provisional application No. 61/791,518, filed on Mar. 15, 2013,both of which are incorporated herein by their entirety.

FIELD OF THE DISCLOSURE

The embodiments of this disclosure are directed to a strap, particularlyto a progressive strap assembly for use with an orthopedic device.

BACKGROUND

Knee braces and supports are widely used to treat a variety of kneeinfirmities. Such braces may be configured to impart forces or leverageon the limbs surrounding the knee joint to relieve compressive forceswithin a portion of the knee joint or to reduce the load on that portionof the knee. If knee ligaments are weak and infirm, a knee brace maystabilize, protect, support, or rehabilitate the knee.

The knee is acknowledged as one of the weakest joints in the body andserves as the articulating joint between the thigh and calf musclegroups. The knee is held together primarily by small but powerfulligaments. Knee instability arising out of cartilage damage, ligamentstrain, and other causes is relatively commonplace since the knee jointis subjected to significant loads during the course of almost any kindof physical activity that requires using the legs.

A healthy knee has an even distribution of pressure in both the medialand lateral compartments of the knee. It is normal for a person with ahealthy knee to place a varus moment on the knee when standing so thepressure between the medial and lateral compartments is uneven but stillnatural.

One type of knee infirmity that many individuals are prone to having iscompartmental osteoarthritis. Compartmental osteoarthritis may arisewhen there is a persistent uneven distribution of pressure in one of themedial and lateral compartments of the knee. Compartmentalosteoarthritis can be caused by injury, obesity, misalignment of theknee, or aging of the knee.

A major problem resulting from osteoarthritis of the knee is that thesmooth cartilage lining the inside of the knee wears away. This leads toa narrowing of the joint space, and therefore the knee develops cystsand erosions in the bone ends. Because of the narrowing of the joint,bone comes directly in contact with bone, and an uneven distribution ofpressure develops across the knee, which may cause the formation of bonespurs around the joint. All of these changes ultimately lead toincreasing pain and stiffness of the joint.

While there are no cures to osteoarthritis, there are many treatments.Individuals who have a diagnosis of isolated medial compartmentalosteoarthritis of the knee are confronted with a variety of treatmentoptions such as medications, surgery, and nonsurgical interventions.Nonsurgical interventions include using canes, lateral shoe wedges, andknee braces.

Knee bracing is useful to provide compartment pain relief by reducingthe load on the compartment through applying an opposing external valgusor varus moment about the knee joint. Unloading knee braces have beenshown to significantly reduce osteoarthritis knee pain while improvingknee function.

Straps used in an unloading knee brace are commonly referred to asdynamic force straps (DFS), and create unloading as the straps becometaut, yet due to the mechanics of the brace, the straps only become tautwhen the knee is close to full extension. As shown in FIG. 1, theunloading is only achieved at low degrees of flexion. In referring toFIG. 2, during normal gait, loading of the knee only happens whenflexion angles are less than 15-20 degrees.

During activities, such as walking up stairs and steep slopes, loadingcan occur at greater flexion angles than those required under normalwalking circumstances. The knee angles during stair ascent can be seenin FIG. 3, which demonstrates that unloading should be provided forflexion at greater angles. Conventional dynamic force straps fall shortof providing unloading at such greater angles.

Microfracture surgery can be an indication for unloading braces.Microfracture surgery is only indicated if the unloading type brace canprovide unloading at the flexion at which the cartilage defect is partof the joint contact surface. Such unloading at the required degree offlexion is not typically obtainable with conventional dynamic forcestraps.

SUMMARY

Embodiments of the disclosure are related to a progressive force strapassembly for use with an orthopedic device. By “progressive,” thedisclosure connotes that the strap assembly is capable of providing aconsistent or maintaining a minimum level of force on a user when thestrap assembly is tensioned over the course of a specified movement. Inan unloading knee brace, the strap assembly maintains a minimum forceapplied to a joint over the entire gait cycle.

In an embodiment of the disclosure, a progressive force strap includesan elongate, inelastic body having first and second ends, and an elasticbody having first and second ends. The first end of the elastic body issecured to the second end of the inelastic body, is arranged to stretcha plurality of lengths, and has a maximum stretchable length. A tensionlimiter is connected to the first and second ends of the elastic bodyand is arranged to inhibit a predetermined stretchable length of theelastic body short of the maximum stretchable length.

While the inelastic body and the tension limiter are preferablyflexible, the elastic body is both flexible and elastic, whereby beingelastic it can stretch and return to a predetermined shape with nopermanent or only minimal deformation. The inelasticity of the inelasticbody prohibits stretching beyond its predefined length, width, or otherdimension.

A dosing device may be coupled to the second end of the elastic body andpermit incremental adjustment of the inelastic body relative thereto.The dosing device may include a tensioning mechanism and an elongateelement adjustably secured to a retainer and coupled to the tensioningmechanism. The elongate element may be within a sleeve-forming part ofthe dosing device. The sleeve may define a plurality of indiciarepresenting loading levels. Other types of dosing devices may be usedincluding those having a linear ratchet.

In a variation of the progressive force strap assembly, the tensionlimiter includes a plurality of stitches in a predetermined pattern andlimits elongation of the elastic body. The plurality of stitches may bearranged in a non-linear configuration when the elastic body is in anon-tensioned state. The stitches are adapted to stretch and elongatewhen the elastic body is in a tensioned state and inhibit stretching ofthe elastic body before it reaches its maximum stretchable limit.Alternatively, the stitches may be arranged in a linear configuration sothat they are stretchable but reach their own maximum stretchable limitbefore the elastic body reaches its maximum stretchable limit.

In yet another variation of the progressive force strap assembly, thetension limiter is an inelastic segment separate from the inelastic bodyand has first and second ends secured to the first and second ends ofthe elastic body. The inelastic segment has a length greater than theelastic body when the elastic body is in a relaxed condition, but thelength is less than the maximum stretchable length of the elastic body.The tension limiter may have a width less than the width of the elasticbody and may be more flexible and/or lightweight than the elastic andinelastic bodies.

A dosing device may be connected to the second end of the elastic bodyand a second end of the tension limiter. A sleeve may be connected tothe dosing device through which the second ends of the elastic body andthe tension limiter are arranged to slide upon operation of the dosingdevice. The dosing device may include a track and the second ends of theelastic body and the tension limiter may secure to a retainer slidablyengaging the track arranged to guide movement of the retainer.

In another embodiment, the first end of the elastic body may be anchoredto the inelastic body and have a length short of a total length of theinelastic body. The elastic body may overlap at least a segment of thetotal length of the inelastic body. The length of the elastic body mayspan a segment of the inelastic body short of the total length. Theelastic body may be anchored at first and second locations within thetotal length of the inelastic body.

In a non-tensioned state, the elastic body spans a segment distancedefined between first and second locations of the inelastic body. Theelastic body has a shorter length in the non-tensioned state than thesegment distance of the inelastic body. In a tensioned state, astretched length of the elastic body is limited by the segment distanceof the inelastic body.

The elastic body may have generally the same width as the inelasticbody, but generally has a shorter length than the inelastic body. Also,at least with unloading braces, the elastic body is preferably connectedat an end of the inelastic body proximate or adjacent to the orthopedicdevice.

Variations of the elastic and inelastic bodies may be employed incombination with or without a tension limiter, and various materialproperties of the elastic and inelastic bodies and tension limiter maybe selected accordingly. Variations may also include modifications ofplacement of the elastic body relative to the inelastic body, and theembodiments are not limited to the inelastic body being at or proximateto an end portion of the progressive strap assembly.

An orthopedic device may include the progressive strap assembly underthe disclosure. The orthopedic device includes a frame having at leastfirst and second portions, and a progressive force strap assemblyincluding an elongate, inelastic body having first and second ends andan elastic body having first and second ends. The first end of theelastic body is anchored to the second end of the inelastic body, andthe first end of the inelastic body is connected to the first portion ofthe frame, and the second end of the elastic body is connected to thesecond portion of the frame. The progressive force strap assembly isadjustable in length and tensionable between the first and second frameportions.

Various methods may regulate the stretching of the elastic strap body,including the provision of a tension limiter in combination with adosing device. Such methods with the dosing device include regulating avariable or progressive strap tension over a limb or limbs of a user andoperatively accounting for movement of the limb or limbs at a joint byadjusting tension in the progressive strap assembly. The methods includepreventing stretching of the elastic body beyond a predefined length bya tension limiter, whereby such predefined length is preferably short ofa predetermined maximum length of the elastic body.

While described with a knee unloading brace, the progressive force strapassembly may be employed in a variety of orthopedic devices that includestraps applied a force to a body.

The numerous advantages, features, and functions of the embodiments willbecome readily apparent and better understood in view of the followingdescription and accompanying drawings. The following description is notintended to limit the scope of the strap assembly, but instead merelyprovides exemplary embodiments for ease of understanding.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features, aspects, and advantages of the presentinvention will become better understood regarding the followingdescription, appended claims, and accompanying drawings.

FIG. 1 is a graph showing a force curve of a prior art dynamic forcestrap.

FIG. 2 is a graph showing a knee flexion angle over gait.

FIG. 3 is a graph showing knee flexion during stair walking.

FIG. 4 is a schematic view of an embodiment of a progressive force strapaccording to the disclosure.

FIG. 5 is a schematic view of another embodiment of a progressive forcestrap in a non-tensioned state.

FIG. 6 is a schematic view of the dynamic force strap of FIG. 5 in atensioned state.

FIG. 7 is a schematic view of another embodiment of another progressiveforce strap in a non-tensioned state.

FIG. 8 is a schematic view of the dynamic force strap of FIG. 7 in atensioned state.

FIG. 9 is an exemplary graph showing a force curve of a progressiveforce strap.

FIG. 10 is another exemplary embodiment of a progressive strap assemblyincluding a tensioning mechanism.

FIG. 11 is a variation of a base plate for a progressive strap assembly.

FIG. 12 is a rear schematic view of a progressive strap assemblyincluding the base plate of FIG. 11.

FIG. 13 is a front schematic view of the progressive strap assembly ofFIG. 12.

FIG. 14 is a front schematic view of the progressive strap assembly ofFIG. 10 pivotally mounted on a buckle.

FIG. 15 is a rear schematic view of the progressive strap assembly ofFIG. 14.

FIG. 16 is a front schematic view of a variation of the progressivestrap assembly of FIG. 10.

FIG. 17 is a side view of the progressive strap assembly of FIG. 16 in afirst, relaxed condition.

FIG. 18 is a side view of the progressive strap assembly of FIG. 16 in asecond, intermediate condition.

FIG. 19 is a side view of the progressive strap assembly of FIG. 16 in athird, tensioned condition.

FIG. 20 is an exemplary embodiment of the progressive strap assembly ofFIG. 16 on an orthopedic device.

In the various figures, similar elements are provided with similarreference numbers. The figures are not drawn to scale or proportion, butinstead are drawn to provide a better understanding of the componentsand are not intended to be limiting in scope but rather provideexemplary illustrations.

DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS

Referring to FIG. 4, a progressive strap assembly 10 includes anelongate, inelastic body 12 having first and second ends, and an elasticbody 14 having first and second ends. The first end of the elastic body14 is anchored to the second end of the inelastic body 12 along ananchor point including stitches 18. In a non-tensioned state, theelastic body 14 has a first length 16 multiplied when the elastic body14 is in a tensioned, stretched state.

The strap assembly 10 is connected to first and second portions of anorthopedic device frame 24, such as a knee unloading brace. The strapassembly 10 is adjustable in length and progressively tensionablebetween the first and second frame portions of the orthopedic device.The elastic body 14 is preferably connected to an end of the inelasticbody 12, and is located proximate or adjacent to the orthopedic device.

A dosing device may be coupled to the second end along an anchor pointof the elastic body 14 and permits incremental adjustment of theinelastic body 12 relative thereto. The dosing device may include atensioning mechanism 22 and an elongate element or cable 26 adjustablysecured to a retainer 28 and coupled to the tensioning mechanism 22. Thecable 26 may be within a sleeve 20 forming part of the dosing device.The sleeve 20 may define a plurality of indicia 32 representing loadinglevels.

The dosing device may be of the type described in U.S. application Ser.No. 13/739,491, published as U.S. patent application publication no.2013/01846627, published on Jul. 18, 2013, and the linear or dialtensioning mechanisms may be of the types described in U.S. Pat. No.7,198,610, granted on Apr. 3, 2007, both of which are incorporatedherein by their entirety. Examples of the orthopedic device and themanner in which the strap assembly secures to portions of the orthopedicdevice are provided in U.S. application Ser. No. 13/739,491 and U.S.Pat. No. 7,198,610.

The inelastic body may be constructed from a variety of textiles andother suitable materials, and the reasons for the inelastic strap are astaught in U.S. Pat. No. 7,198,610. The elastic body may be formed by anysuitable elastic material, including textiles, polymeric materials,rubber, etc.

Referring to the embodiment of FIGS. 5 and 6, the progressive strapassembly 40 includes an elongate, inelastic body 42 having a totallength and an elastic body 44 having first and second ends. The firstend of the elastic body 44 is anchored to the inelastic body 42 at firstand second locations 50, 52, respectively, and has a length 48 in anon-tensioned state short of the total length of the inelastic body 42.The elastic body 44 overlaps at least a length segment 49 of the totallength of the inelastic body 42. The length 48 of the elastic body 44may span the length segment 49 of the inelastic body 42 short of thetotal length. The first and second locations 50, 52 are preferablywithin the total length of the inelastic body 42.

The non-tensioned length 48 of the elastic body 44 is preferably lessthan the length segment 49 of the inelastic body 42.

When the elastic body 44 is in the non-tensioned state, the elastic body44 generally spans the length segment 49 defined between first andsecond locations of the inelastic body 42. The inelastic body 42 islooped or bows outwardly to form a slackened segment 46 to accommodatethe difference in length among the length segment 49 of the inelasticbody 42 and the non-tensioned length 48 of the elastic body 44.

When the strap assembly is in a tensioned state, the stretched length ofthe elastic body 44 is limited by the length segment 49 of the inelasticbody 42 in which the slackened region 46 is removed and the tensionedlength of the elastic body 44 and the segment length 49 are the same.The slackened region 46 is removed by the inelastic and the elasticbodies 42, 44 therefore being coextensive across the segment length 49,as depicted in FIG. 6. The inelasticity of the inelastic strap 42 incombination with the removal of the slackened region 46, and theelasticity of the elastic body 44 makes both coextensive, whereas in thenon-tensioned state, the elastic and inelastic bodies are notcoextensive since the elastic body 44 is shorter than the segment length49.

Another embodiment of the strap assembly 60 is in FIGS. 7 and 8. Thestrap assembly 60 includes an inelastic body 62 and an elastic body 64having a plurality of stitches 66 that are arranged in a zig-zagconfiguration when the elastic body 64 is in a non-tensioned state.

The embodiment relies on the misalignment of stitches or other meansrelative to the length of the elastic body when the elastic body is in anon-tensioned state and an alignment of the stitches or other meansrelative to the length of the elastic body when it is in a tensionedstate.

The elastic body 64 has first and second ends 70, 72, respectively,which are anchored at first and second ends of first and second segmentsof the inelastic body 62. Alternatively, only the first end 70 isanchored to an end of the inelastic body 62, and the second end 72 issecured to the orthopedic device frame or other component connected tothe orthopedic device frame.

The stitches 66 are preferably formed from an inelastic thread, whereasthe remainder 67 of the inelastic body 62 is elastic. The elastic body64 has a first length 68 in the non-tensioned state and a maximum secondlength 69 in a fully tensioned state. In the fully tensioned state, thestitches 66 are elongated from the zig-zag configuration and limitfurther stretching of the elastic body 64.

The stitches are not limited to a zig-zag configuration and may bearranged in other configurations that permit elongation of the elasticbody but also are adapted to limit stretching of the elastic body aftera certain length. The embodiment is not limited to stitches, but othermeans may be in combination with the remainder to allow stretching butinhibit a certain length of stretching.

FIG. 9 shows how the progressive strap assembly of the disclosure makesthe force curve of a dynamic force strap more progressive over the priorart strap assemblies. The advantage of the progressivity of the strapassembly is it allows for better improvement of pain relief experiencedby users of unloading type braces that use dynamic force straps. Thestrap assembly of the disclosure unloads through a greater range ofmotion and allows for better pain relief when mounting stairs. It alsoassists in microfracture surgery rehabilitation.

Constant tension in the strap assembly prevents migration of theorthopedic device since there is a constant force applied over movementof the user. This allows for better comfort and compliance.

FIG. 10 illustrates another progressive strap assembly 100 including abase plate 102, a tensioning mechanism 104, and elongate elements orcables 106 extending from the tensioning mechanism 104 and secured to aretainer 108 mounted on a first end 111 of an elastic body 110. Theelastic body 110 has a second end secured to another strap body 112,which is preferably inelastic, along stitching 113 or other interfaceused to connect the elastic body 110 and the strap body 112. A first endof the base plate 102 is pivotally mounted at pivot point 114 to ashell, buckle, or other brace component. A flexible sleeve 116 isarranged to cover the cables 106 and portions of the base plate 102.

In operation, the cables 106 transmit tension through the elastic body110 for reasons discussed above. The inelastic body 112 forms themajority of the length of the strap, whereas the elastic body 110 isgenerally only at the end portion of the strap coupled to the cables.This arrangement may be modified so the inelastic body 112 is lengthenedand need not form a majority of the length of the strap.

Unlike in the embodiment of FIG. 4, which forms a button-hole and hookconnection to a shell, the pivot point 114 is preferably a rivet thatenables the strap assembly 100 to rotate relative to the component uponwhich it is mounted. In the embodiments of FIGS. 14 and 15, the pivotpoint 114 is on a buckle 140, which may be secured to a shell, cuff orother component. The pivot point 114 enables the strap assembly togenerally conform to the shape of the anatomy individually respective toa user of a brace or support carrying the strap assembly, whichattributes to better fit of a brace or support.

The pivot point 114 may be on top or behind a buckle, shell, cuff, orother component depending on the configuration in which the strapassembly is used. This allows flexibility at where the strap assembly100 can be mounted. By using a pivot point such as a rivet, the strapassembly can be at higher locations on a knee brace, making it easierfor a user to reach the tensioning mechanism.

As shown in FIG. 10, the pivot point 114 is preferably located outsideof the tensioning mechanism 104. This allows for an area for additionaladjustment and does not interfere with the tensioning mechanism 104. Inan alternative embodiment, the pivot point may include a ball joint thatenables pivoting outward and inward adjustment besides pivoting movementdiscussed with the rivet pivot point 114.

In this embodiment, the cover 116 is preferably a textile rather than aplastic, rubber, or otherwise formed cover. The textile-based cover canbe opened (such as through hook and loop fasteners) so the user orclinician has ready access to adjust or modify the cables. Thetextile-based cover is also flexible, lower profile and has less bulk.

FIG. 11 depicts a variation of a base plate assembly 120 including abase plate 122 and ratcheting device 136. The base plate 122 defines afirst end 124 having a shorter length than a second end 126. The firstand second ends 124, 126 are delimited by a bend 136 enabling the baseplate 122 to bend about a user's anatomy.

The first end 124 has a greater thickness than the second end 126, andthe thickness may taper between the first and second ends 124, 126. Thefirst end 124 is flexible, although has sufficient rigidity toaccommodate the tensioning mechanism 104. Parts 132, 134 are provided tosurround at least part of the tensioning mechanism 104 to cover andguard the tensioning mechanism 104.

In referring to the variation of FIGS. 12 and 13, the second end definesa plurality of slots 128 arranged to receive sliders 138 on a bottomside of the retainer 108. The sliders 138 permit the retainer 108 andcoupled cables 106 to track the motion regardless of the flexure of thebase plate 122 over the user's anatomy.

The sliders may be arranged to be removed from the base plate or mayhave a snap fit connection to the base plate with the base plate havingcorresponding openings arranged to receive a shaft of the slider. Forexample, an individual slider has a shaft having a diameter or widthless than the width of the outer slot, and a base connected to the shafthaving a width greater than a width of the outer slots. The slider isarranged to slide freely on the outside of the base plate and parallelto the base plate. The shaft preferably has a length consistent with thethickness of the base plate.

Returning to FIG. 11, the second end 126 of the base plate 122 defines aplurality of inner slots 130 or tracks that allow for greaterflexibility of the second end 126 besides the thinner thickness. Thisarrangement permits free twisting of the second end 126 of the baseplate 122 and allows it to more snugly conform to a user's anatomy, suchas a tibia.

According to the exemplary embodiment of FIG. 16, a progressive strapassembly 200 having a strap including a generally inelastic strap body202 and an elastic body 204 having a first end at which the inelasticstrap body 202 secures along a connection 222 and a tension limiter 206.The connection 222 may comprises a connector, such as a tab or bracket,stitching, or other means for securing the inelastic strap body 202 tothe elastic body 204. The connection may be permanent in that removal ofthe inelastic strap body 202 from the elastic body 204 may damage one orboth of the strap bodies, or the connection may be removable in that theinelastic strap body 202 is easily repeatedly securable and removablefrom the elastic strap body 204.

As with the embodiments described herein, the term “flexible” isdistinguished as being bendable, whereas the term “elastic” isdistinguished as returning to an original shape or size after beingstretched. The term “inelastic” is the opposite of “elastic” in that itis distinguishable as not being capable of being stretched. From theforegoing, a strap body or tension limiter can be flexible in that itbends or yields to a shape, but it cannot be stretched in itslongitudinal, lateral, or orthogonal direction to be lengthened greaterthan a predetermined dimension such as length, width, or thickness. Anelastic strap can be pulled greater than an initial relaxed dimensionupon applying a force and upon release of the force revert to theinitial, relaxed dimension, preferably without permanent or minimaldeformation.

The tension limiter 206 is preferably an inelastic strip of a fabric orplastic strip and has a length greater than the elastic body 204 in arelaxed configuration. The tension limiter 206 may be formed as moreflexible and lightweight than the inelastic body 202, yet both areinelastic. The tension limiter 206 may be a textile-based strip sizedsubstantially thinner and narrower than the inelastic strap body sincethe tension limiter is provided to inhibit stretching of the elasticstrap body beyond a predetermined length. The tension limiter 206according to this embodiment is preferably not intended to bear tensionforces of the strap assembly over a limb, although it is not limited inbeing arranged to do so.

In this embodiment the tension limiter 206 has a width less than a widthof the elastic body 204 to minimize interaction of the tension limiter206 with other brace components upon which the progressive strapassembly may secure or other items that may come into contact with theprogressive strap assembly. Alternatively, the tension limiter 206 mayhave a width substantially the same as the elastic body 206.

In a variation, the tension limiter 206 may comprise a plurality ofstitches along its length in a similar manner as in the embodiment ofFIG. 6, but formed on a strip of material separate from the elastic body204. The plurality of stitches may be formed in a variety of non-linearconfigurations wherein a matrix or substrate carrying the stitches iselastic, and the stitches, when fully elongated from the non-linearconfigurations, inhibit further stretching of the matrix or substrate.In another variation, the stitches may be in a linear configuration butarrive at a maximum stretched length before the elastic body does,thereby inhibiting further stretching of the elastic body beyond themaximum stretched length of the stitches.

In a variation, the tension limiter is defined by an inelastic segmentof the inelastic body overlapping the entire length of the elastic body.The inelastic segment has a length greater than the elastic body whenthe elastic body is in a relaxed condition and is secured to the firstand second ends of the elastic body. The inelastic segment may have thesame width as the elastic body or may have a reduced width.

A dosing device 208 including a tensioning mechanism 209 has at leastone elongate element 210, such as a cable, securing to a retainer 212,such as a tab, secured to a second end of the elastic strap body 204. Asleeve 220, of any of the types described herein, may cover portions ofthe at least one elongate element 210, the retainer 212, the inelasticstrap body 202 and the tension limiter 206. The tensioning mechanism 209and sleeve 220 may be carried by a base 218 belonging to the dosingdevice 208 securable to a brace or frame element (not shown). The base218 may include a slot or keyhole features 216 engageable with a pin orsupport 214 connecting to the brace or frame element.

The dosing device may include the features of the foregoing dosingdevice embodiments, including sliders and retainer, to permit theelastic body to stretch and adjust in a controlled manner.

The progressive strap assembly may be devoid of a dosing device andinstead the end of the progressive strap assembly comprises the secondends of the elastic body and tension limiter, with or without theretainer. In a variation, the progressive strap assembly includes firstand second inelastic bodies secured to the first and second ends of theelastic body, such that the elastic body is bordered at opposed ends byinelastic bodies, rather than merely being at or defining in part an endportion of the progressive strap assembly.

Referring to the schematic views of FIGS. 17-19, FIG. 17 showsprogressive strap assembly 200 in a relaxed condition, particularly withboth the elastic strap body 204 in a non-tensioned state and tensionlimiter 206 slackened. FIG. 18 exemplifies an intermediate conditionwherein the progressive strap assembly 200 undergoes some tensioningwith the elastic strap body 204 being pulled toward and by thetensioning mechanism 209 and increasing in length, and the tensionlimiter 206 being reduced in slack according to the increase in lengthof the elastic strap body 204. FIG. 19 depicts the progressive strapassembly 200 in a fully tensioned condition by further operation of thetensioning mechanism 209 wherein the length of the elastic strap body204 is further inhibited by the tension limiter 206 in a taut condition.The length of the elastic strap body 204 is generally the same as thelength of the tension limiter 206 in the fully tensioned condition.

FIG. 20 shows the progressive strap assembly 200 arranged with anorthopedic device 230. The orthopedic device 230 is in an exemplaryembodiment of a knee brace. The base 218 connects to an upper frame 232,and the progressive strap assembly 200 spirals toward a lower frame 234at which a second end 240 of the inelastic strap body 202 secures. Theupper and lower frames 232, 234 connect to one another by a hingeassembly 236. An additional strap assembly 238 may be arranged betweenthe upper and lower frames 232, 234 in an opposing orientation to theprogressive strap assembly 200.

It should be remembered that the illustrative examples of FIGS. 17-19are depicted without being on a leg of a user. During use, whetheraccording to different positions of gait such as flexion and extensionor due to anatomical changes in a user's leg, the tensioning conditionof elastic strap body may vary with or without tensioning resulting fromthe tensioning mechanism. Rather, the elastic strap body accommodatesmovement of a knee or other joint while maintaining or approximatingforce over the leg or other limb.

Various embodiments and methods for using the same may be devoid of atension limiter used in combination with the elastic body. Rather, thedimension or dimensions of the elastic body such as length, width, andthickness and the elasticity of the elastic body may be selected so themaximum stretchable length is obtainable without a tension limiter andthe progressive strap assembly can be operable with only at least oneelastic body and at least one inelastic body.

It is to be understood that not necessarily all objects or advantagesmay be achieved under any particular embodiment of the disclosure. Forexample, those skilled in the art will recognize that the orthopedicdevice and progressive strap assembly may be embodied or carried out toachieve or optimize one advantage or group of advantages as taughtwithout achieving other objects or advantages as taught or suggestedherein.

The skilled artisan will recognize the interchangeability of variousdisclosed features. Besides the variations described, other knownequivalents for each feature can be mixed and matched by one of ordinaryskill in this art to construct an orthopedic device under principles ofthe present disclosure. It will be understood by the skilled artisanthat the features described may be adapted to other types of orthopedicdevices. Hence this disclosure and the embodiments and variations arenot limited to knee braces, but can be utilized in any orthopedicdevices.

Although this disclosure describes certain exemplary embodiments andexamples of an orthopedic device, it therefore will be understood bythose skilled in the art that the present disclosure extends beyond thedisclosed knee brace embodiments to other alternative embodiments and/oruses of the disclosure and obvious modifications and equivalents. It isintended that the scope of the present disclosure should not be limitedby the disclosed embodiments described above, and may be extended toorthopedic devices and supports, and other applications that may employthe features described.

The invention claimed is:
 1. A progressive strap assembly comprising: astrap having a length defined by an elongate body having a firstelasticity and a first end; an elastic body having first and secondends, the second end of the elastic body anchored to the first end ofthe strap, and having a second elasticity different from and greaterthan the first elasticity of the strap, the elastic body having amaximum stretchable length; a tension limiter having first and secondends secured to the first and second ends of the elastic body,respectively, the tension limiter being non-stretchable in alongitudinal direction and arranged to inhibit a predeterminedstretchable length of the elastic body short of the maximum stretchablelength; a retainer secured to the second ends of the elastic body andthe tension limiter; a dosing device having at least one elongateelement coupled to an end of the retainer, the dosing device arrangedfor incremental adjustment of a length of the at least one elongateelement between the dosing device and the retainer; a flexible sleevesecured to the dosing device through which the at least one elongateelement extends, the second ends of the elastic body and the tensionlimiter are arranged to linearly slide through the sleeve with theretainer upon the incremental adjustment of the dosing device, the firstend of the strap being maintained outside of the sleeve.
 2. Theprogressive strap assembly of claim 1, wherein the tension limiterincludes a plurality of stitches in a predetermined pattern, thestitches limiting elongation of the elastic body at the predeterminedstretchable length of the elastic body.
 3. The progressive strapassembly of claim 2, wherein the plurality of stitches are arranged in anon-linear configuration when the elastic body is in a relaxedcondition, the stitches adapted to stretch and elongate when the elasticbody is in a tensioned condition.
 4. The progressive strap assembly ofclaim 1, wherein the tension limiter is an inelastic segment having alength greater than the elastic body when the elastic body is in arelaxed condition.
 5. The progressive strap assembly of claim 4, whereinthe tension limiter has a width less than a width of the elastic body.6. The progressive strap assembly of claim 1, wherein the sleeve definesa linear row of indicia representing different loading levels accordingto linear movement of the elastic body through the sleeve.